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Autoscopy: Disrupted Self in Neuropsychiatric Disorders and Anomalous Conscious States

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Handbook of Phenomenology and Cognitive Science

Abstract

Autoscopy is a loosely related complex of experiences in which one sees (or experiences) a “double” as external to one’s current vantage point. The phenomenology of autoscopy provides an alternative to current “models” of self in cognitive science. After years of silence on matters such as consciousness and self, cognitive science and neuroscience have now swung in the opposite direction, and claim to be able to experimentally study these topics, often in an oversimplified manner. These approaches uncritically confuse representational content about self or self-awareness in self-referential processing, i.e., having a self (a self-enclosed entity), with being a self, prospectively open to its own (yet-to-be-known) future.1 Ignoring this difference has led to an industry of philosophical essays and neuroimaging studies that claim to access the first-person perspective when only able to access higher order self-referential judgments (for critical reviews, see Fuchs 2006; Legrand et al. 2003; Mishara 2007b). A similar confusion prevails in current approaches to classify types of autoscopy in the search for its underlying cognitive-neural mechanisms.2 Due to its descriptive method and resulting theoretical framework, phenomenology is in a unique position to contribute to the study of human self and its disruption in neuropsychatric disorders.

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Notes

  1. 1.

     By overlooking this important conceptual distinction, self-reference is confused with “being a self” (e.g., Gusnard 2005). By requiring subjects to make explicit, reflective judgments about their emotional experience, for example, they are required (ironically) to take an external, third-person perspective to their experience (See Mishara 2005, 2007b).

  2. 2.

     Although the term “neurocognitive” is in vogue, I deliberately do not use it. It circumvents the mind-body (or mind-brain) problem or simply, treats it as already solved. Although associated with one another (as in lesion or neuroimaging studies), cognitive and neural are different levels of explanation (see Mishara 2007b). According to the “revolving door principle” (von Weizsäcker (1948), whose work is described in this contribution and elsewhere (Mishara 1994)), our access to cognitive (mind) and neural (brain) remains dual: cognitive and neural presuppose but also exclude one another (as two sides of a coin) in terms of a “hidden unity.” We will examine how this “hidden unity” is disrupted in autoscopy.

  3. 3.

     The more recent taxonomies of autoscopy (Blanke and Mohr 2005; Brugger 2002; Brugger et al. 1997; Grüsser and Landis 1991; Lopez et al. 2008) draw from the earlier classificational systems (Conrad 1953; Hécaen and Ajuriaguerra 1952; Lhermitte 1939; Menninger-Lerchenthal 1935; Sollier 1903). The major difference between the classification I propose here and those preceding is that I label the second type of autoscopy, “delusional (dream-like) autoscopy,” often labeled heautoscopy (Brugger et al. 1997; 2002; Blanke and Mohr 2005; Lopez et al. 2008). See Tadokoro et al. (2006) for a different classification system.

  4. 4.

     Unlike hallucinations proper, the person experiencing “pseudohallucinations” retains insight that the experience is unreal (Sedman 1966).

  5. 5.

     The term “coenesthesia” was common until the beginning of the twentieth century when it was replaced by terms such as “body schema” and “body image” (e.g., Head and Holmes 1911; Head 1920; for Sir Henry Head’s influence on German Phenomenological psychiatrists, especially Klaus Conrad, see Mishara in press a). It derives from the Aristotelian doctrine that information from the exteroceptive senses (vision, audition, touch, smell) only reaches ‘internal sense’ by means of common sense (sensus communis, koinon aesthesis), therefore the German, Gemeingefuehl (see Fuchs 1995). The sense of bodily existence, i.e., the very feeling that one is alive, that one’s body exists, lies at the core of the human experience of self. This feeling of being alive subserved by an interoceptive neural pathway (and related reward-emotion processing) gives rise to the “myness” of my experience and may be disrupted in schizophrenia and other neuropsychiatric disorders (see Mishara 2004).

  6. 6.

     Whereas Type I patients see the autoscopic body in front-view, Type II patients sometimes report seeing the autoscopic body in side- or back-views. Ionasescu (1960) reports a hairdresser, who saw his own autoscopic body from the side while cutting hair (cited by Blanke and Mohr 2005). Brugger (2002) interprets non-frontal Type II autoscopy (i.e., heautoscopy) to be computationally less demanding than full frontal views for the visual and other neural systems supporting the hallucination: “This type of visualization may spare the cognitive system the trouble of mentally ‘turning around’ in order to maintain consistency in the sidedness of the original and duplicated bodies” (p. 187). However, Brugger and colleagues (2006) report a case of “polyopic heautoscopy” (in which more than one double is experienced at the same time) which suggests that such reductions in computational complexity are not always present in Type II autoscopy. Upon seeing the first double, the patient reports his efforts of trying to discover its identity: “When I walked around, I repeatedly looked towards the gentleman on my side and wondered if I could recognize his face. This was impossible since on looking towards the right side he also turned his head to the right.” (p. 669). This suggests that rather than reducing the computational complexity, the Doppelgänger - by precisely mimicking the patient’s own efforts to discover the double’s identity - not only evades the patient’s efforts but does so with an exquisite precision that reproduces the egocentric computations and timing of the subject’s own head movements!

  7. 7.

     In E.T.A. Hoffmann’s (1967) remarkable short story, New Year Eve’s Adventure (Die Abenteuer der Sylvester-Nacht), the narrator - following a painful romantic disappointment at a New Year’s party - finds himself in a smoky, basement pub, with two new acquaintances, one who has lost his mirror image in a similar romantic disappointment and another man who has unhappily sold his own shadow. Unable to go home, the narrator is mistakenly given the same hotel room as the man who has lost his mirror image. In the morning, he wakens to find that his unwanted roommate has already departed but has left behind a manuscript in which the author (named Erasmus) describes in 3rd person how he lost his mirror image. Critical for our discussion of Type II autoscopy is Erasmus’ depiction of how the mirror image becomes detached and acts independently of the subject’s intended movements: “Erasmus saw his image step forward independent of his movements, glide into Giuletta’s arms and disappear in a vapor” (Hoffmann 1967, p. 122). For the justification of using literary depictions as evidence for (abnormal) structures of self, see phenomenological method, step 2, below.

  8. 8.

     The “classical” psychopathological view (e.g., Jaspers, Gruhle, K. Schneider) is that ‘‘delusions can only arise in the process of thinking and judging.’’ In contrast, some phenomenological-psychiatrists (e.g., Binswanger, Conrad, Blankenburg) hold the view that delusions are related to more automatic processes, not unlike dreaming (Mishara 1997; Uhlhaas and Mishara 2007). Conrad (1958; 1960) believes that the delusional schizophrenia patient is “caught between waking and sleeping” see Mishara in press a; in press b.

  9. 9.

     When we view an image in a mirror parallel to one’s own face and body, we are aware of a left-right but not a top-bottom reversal (Navon 2001). As a result, there is considerable discussion to what extent the “illusory” experience of self in the mirror image is due to top down cognitive processes or the bottom up processing of the optical geometry (see Navon 2001, and commentaries). Because the experience of the mirror occurs in conscious visual perception, it is experienced as a doubling of the visible body or body image. What is often overlooked, the mirror image is computed - like Type I autoscopy - in allocentric, object-centered coordinates. Lacan (1977) and others following (e.g., Merleau-Ponty) point to the following phases in the experience of mirror reflection: (1) a perceptual captivation in the mirror reflection; (2) a motoric phase in which the subject (initially the infant) takes glee in having the mirror image follow the movements which he or she initiates, (3) An anticipated, “illusory” totality of one’s self integrates the perceptual and motoric moments or ‘selves’.

  10. 10.

     Wisdom (1953) distinguishes his concept of “phantom body” from body image: “Thus when one sees oneself in a dream or in a mirror the part of the visual body-image that is seen does not coincide with the phantom-body … That is to say that no fusion takes place between the phenomena these refer to: for in fact we usually find an approximate coincidence between the phantom-body and visual body-image.” That is, the two selves (i.e., perceptual and motor, or body image and body schema, respectively) are usually integrated in everyday experience but are vulnerable to separation in neuropsychiatric disorders and anomalous conscious states. For the strikingly similar views expressed by phenomenological “anthropological” thinkers Plessner and von Weizsäcker, see Mishara (in press c): “The constant shifting between being/having a body - what Pleesner eccentric positionality - is often “overlooked” in everyday common-sense experience (von Weizsäcker; Plessner)” but disrupted in neurologic or psychiatric disorder.

  11. 11.

     For example, rape victims sometimes report dissociative experiences, “such as the sense of watching the rape from outside their bodies” (Foa and Riggs 1993, p. 281).

  12. 12.

     In his short story, “The Bucket Rider,” Kafka (1979) depicts the feeling of a passively floating OBE-like experience humorously: The protagonist has the unique ability to ride his bucket through the village precisely because he has run out of coal and the bucket is empty: “I must have coal; I cannot freeze to death; … Seated on my bucket, my hands on the handle, the simplest kind of bridle, I propel myself with difficulty down the stairs, but once downstairs my bucket ascends superbly, superbly” (pp. 412–413). While hovering outside the coal-dealer’s window and appealing to the latter’s wife for some coal, he describes his experience: “She sees and hears nothing; but all the same she loosens her apron strings and waves her apron to waft me away … My bucket has all the virtues of a good steed except powers of resistance, which it has not; it is too light; a woman’s apron can make it fly through the air … And with that I ascend into the regions of the ice mountains and am lost forever.” (p. 414). Kafka frequently wrote at night during a sleep-deprived state. It is likely that he drew from his own hypnagogic imagery for this and other stories. In his Diaries, Kafka describes his nocturnal writing as conducted “entirely in darkness, deep in his workshop” (Kafka 1965, p. 518; see also Kurz, 1980). After writing “The Judgment” in one sitting, he praises the advantages of writing without sleep. It enables access to unusual thoughts and associations which otherwise would not be possible: “How easily everything can be said as if a great fire had been prepared for all these things in which the strangest thoughts emerge and again disappear” (Kafka 1965, pp. 293–294, my translation). That is, during writing, he experiences a transformed state of consciousness: “All I possess are certain powers which at a depth almost inaccessible at normal conditions, shape themselves into literature …” (Letters to Felice, 1973, p. 270).” Perhaps reflecting these abnormal, hypnogogic-like states, there are numerous examples in Kafka’s (1979) writings of autoscopic doubling in which the mirroring becomes obstructive to the protagonist’s own objectives. In “Descriptions of a Struggle” (Kafka’s earliest published story, version A written 1903-1904; version B, 1909), the narrator’s companion (an acquaintance just made at a party) continually does the opposite to what the protagonist anticipates, e.g., he walks too slow or too fast. However (as in Type II autoscopy), the narrator suddenly finds himself so embroiled that he catches himself mirroring (!) his companion: “he began walking again and I followed without realizing it…” (Kafka, 1973, p. 13) As much as the narrator desires to escape, he is unable to disentangle himself from the acquaintance as if they were each incomplete, or different sides of the same person. The “literary evidence” supports the phenomenological argument explicated here that autoscopy and intersubjectivity are related. For the phenomenological analysis of how Kafka’s writings may reflect a hypnagogic process of hallucinating paranoid doubles of self (following social, sensory and sleep deprivation) with reference to Husserl’s theory of intersubjectivity and the possible underlying cortical excitability of a social network in the brain, see Mishara (in press d).

  13. 13.

     This concurs with Ralph Hoffman’s (2007) hypothesis that sensory/social deafferentation (and associated cortical excitability) in patients with schizophrenia contribute to their positive symptoms (hallucinations, delusions). Similarly, subjects who participated in John Lilly’s “isolation” (sensory-deprivation) tank experiments (floating in darkness with the salt-water at body temperature) reported both hallucinations, and eventually, delusions.

  14. 14.

     “Several observations make clear that this ‘person,’ often referred to as a shadow, is nothing more than a projection of the own body representation into extracorporeal space” (Brugger, 2007, p. 212).

  15. 15.

     Jaspers (1913) draws from Ach’s (1905) term Bewusstheit, i.e., the making present of something known to ‘awareness’ but not directly given to perception (Bewusstheit = Gegenwärtigsein eines unanschaulich gegebenen Wissens (Ach 1905)).

  16. 16.

     Hoffman et al. (2003) found that slow repetitive TMS, which decreases the excitability of the underlying cortex, reduced the incidence and severity of treatment-resistant auditory hallucinations (when applied to the left temporo-parietal region). However, even after alleviation from the distressing hallucinations, some patients report that they can still “feel the voices,” i.e., the “presence” that gives rise to them (R. Hoffman, personal communication). Presumably, these feelings arise from activity in neighboring brain areas (see Fig. 2 and discussion of neural correlates, below). As further indication of a presence ‘behind’ the voices, I interviewed a schizophrenia patient who refers to her recurrent auditory hallucinations as “presences.” She reported that the “presences will wait to talk” with her while she is doing some other activity such as reading. However, she senses their “presence” so strongly that she feels obliged to stop reading and initiate “conversation” with them.

  17. 17.

     Peter Brugger reports having observed other (unpublished) cases in which an initially visual experience of heautoscopy (Type II autoscopy) recedes over days or even weeks to later become the feeling of an invisible double (FOP) (personal communication).

  18. 18.

     Husserl’s method of abstracting, or delimiting the meaning of an object by means of imaginative variation of its limits, establishes the formal conditions of its possibility (see Seebohm 1962). By suspending our belief in the object’s actual reality (Step 1), we explore its possible imagined, variant meanings (latent or implicit to the initial perception) (Step 2). What is common to each variant (i.e., a sample of the core-meaning according to the underlying “type”) is actively maintained across variants. After sufficient sampling, there results a “seeing of the object’s essential structure” (Wesenschau) initially present (in a concealed manner) in the perception (see the discussion of perceptual “type” below). By means of imagination alone, Goethe (1790) thought that he accessed a “primal plant” (Urpflanze) that provides the formula, rule, or law” (Formel, Regel, Gesetz) for the appearance of plants in general. This approach may be considered a distant precedent to Husserl’s method. Unlike Husserl, however, who was proposing a method to discover the underlying structures of consciousness, Goethe thought that he was directly studying the laws of nature. C.G. Jung (a contemporary, whom we know Husserl had read from underlinings in his library copy of Jung’s Versuch einer Darstellung der Psychoanalytischen Theorie, 1913) had developed a related method called “active imagination.” This method is intended to reveal unconscious meaningful structures (so-called “archetypes”), which (not unlike Husserl’s type or eidos), once triggered or activated, play a role in ‘determining’ the conscious experience. Phenomenological-psychiatrists and researchers (e.g., Binswanger, Buytendijk, Tellenbach) justify their use of literature as a source for phenomenological “data” for providing the structures of healthy (and abnormal) consciousness by referring to Husserl’s second methodical step, imaginative variation.

  19. 19.

     The phenomenological method (which I present here in a simplified manner) has been criticized as being less transparent than it claims (e.g., Gadamer 1993). It is very difficult to explicitly follow a method without implicitly employing the eventual “expertise” that accrues through practice (i.e., the procedural know-how and accompanying “prejudices” (Vor-urteile) we acquire over time and apply without awareness) (See Mishara, 2007b). Similarly, Merleau-Ponty (1973) observes that phenomenological reduction (i.e., reflection on our experience) is inevitably mediated by language even when we claim to be describing nonverbal, pre-linguistic, “mute” sources of meaning (see the discussion of “type” below).

  20. 20.

     The phenomenological-psychiatrist, “Blankenburg and Mishara ((1969) 2001; 1971) observes that “our mental health is preserved by a certain ‘resistance’ to loosing our common sense. This resistance functions precisely by overlooking the obvious as obvious. The obvious … does not require further exploration; it even ‘resists’ further exploration” (Mishara 2001, pp. 319–320).

  21. 21.

     Every reflecting on our experience itself occurs within the temporal passing of consciousness and is subject to the same “laws” of “time consciousness” as the original reflected on experience (see Yamaguchi 1982).

  22. 22.

     These observations, of course, do not overlook “prospective” reflection (see Buckner and Caroll 2007, for recent review). However, in both prospective and retrospective (explicit) reflecting - even as I plan tomorrow’s activities - the self is experienced as object. The episodic/declarative memory system (retrospective or prospective) is mediated by medial temporal lobe, which receives input from both ventral and dorsal visual processing streams, so-called “what” (allocentric) and “where” (egocentric) pathways, respectively (Eichenbaum et al. 2007). Nevertheless, explicit remembering and prospection may be exclusively cast in scene-based, allocentric coordinates, in which the “remembered” or “projected” self is always object or a me. It may be impossible to have a reflective or explicit view of self which is not object (Mishara 2007b). The first person spoken “I” (see below) does nothing to change the reflected self’s status as object.

  23. 23.

     Husserl (1966) observes that, when we are caught up in perceiving or experiencing things, there is a loss of self (Selbstverlorenheit), a naivety about our role in constructing the experience: “Admittedly, the moment I begin to reflect, the naïve perceiving by the self-forgetting I is already past. I am only able to grasp this by reaching back - in the reflecting - into what has ‘remained in consciousness’ as retention, an immediate memory which attaches itself backwards to the original experience” (p. 88, my translation and emphases). I am able to reflect on my original naïve self-forgetting which is absorbed in the experiencing only because the I itself has ‘split’ (Ichspaltung) into a reflecting I and the object of its reflection, the naïve I just previously engrossed in experiencing (i.e., the self as object or a “me”). Husserl argues that we are nevertheless assured that they are the same “I” because both are experienced in the retrospective reflection as “belonging to the same streaming present” (p. 89, my translation).

  24. 24.

     In this regard, Zutt (1953, p. 26) cites the phenomenological-philosopher, Heidegger (1927), “In directing one’s attention to … or grasping something, the existing subject (Dasein) does not proceed from some ‘inner sphere’ in which he is at first encapsulated. Rather, the subject’s primary mode of being is to be always already ‘out there’ with the things he is encountering, with the world as it discloses itself” (1927, p. 62, my translation). That is, the being-in-the-world of the subject is ec-static (from the ancient Greek, ek out + histanai, cause to stand), i.e., as a subject standing outside him- or herself in engagement with the world.

  25. 25.

     “This is so because my body is already always there in the perceptual field as body subject…” (Husserl 1959, p. 62, my translation).

  26. 26.

     When perceiving others, what is at first “… given is the outside of another living body. This is apprehended as living because an inside is associated with it through an associated transfer of the inside/outside structure given with my primordial body. This inside appresents (i.e., makes present) another simultaneous here-now which is not mine and cannot be united with my own here-now …” (Seebohm 1989, p. 373, my parenthetical insertion and emphases).

  27. 27.

     Because the other’s body is always “there” and can never occupy the “absolute Here” of my body, “the other body can never be given to me as my own living-body” (Held 2003, p. 52).

  28. 28.

     Husserl’s phenomenology anticipated later developments in cognitive science. For example, Husserl’s distinction between “active” and “passive” mental processes overlaps with the later cognitive distinction between controlled (i.e., effortful, limited capacity) vs. automatic processing (Mishara, 1990; Wiggins, 1994; Wiggins and Spitzer, 1997). For Husserl’s account of how phenomenology penetrates into “deeper” layers of nonconscious, automatic processes, see Mishara, 1990. Similarly, Binswanger (1957; 1965) regards psychosis as a “natural experiment” in which the researcher is able to examine “deeper,” nonconscious levels of meaning. It is as if the layers of our experience were suddenly exposed, layers that otherwise would not be accessible (Mishara in press a).

  29. 29.

     Merleau-Ponty’s project may be seen as a continuation of Husserl’s radical approach to cognition. By revolutionizing our view of embodied cognition, he proposes a new vocabulary for the study of human self and experience: “Replace the notions of concept, idea, mind, representation with the notion of dimensions, articulation, level, hinges…” (1968, p. 224). In order to realize this project, Merleau-Ponty (1968) employs metaphorical language, e.g., “chiasm,” “hinge,” “flesh.” These are meant to describe the relationship between a body for self (body subject) and body for others (body as object) as an ongoing, “reversible” relationship (critical for the current phenomenological approach to autoscopy). Many of the passages that employ these metaphors, which I cite here, are written in note form for a never completed book project (1968) shortly before Merleau-Ponty’s untimely death. Therefore, they are suggestive but, unfortunately, incomplete. See Mishara (2007a) for the (inevitable) role metaphors play in both the self’s own expression and its neuroscientific study.

  30. 30.

     Merleau-Ponty describes how one “structure” shared between conversational partners enables the (automatic, anticipatory) transitions required for turn-taking: “Speaking and listening, action and perception, are quite distinct operations for me only when I reflect on them.… The synthesis of coupling or transition … (of) looking/gesture, listening/speaking … begin as simple modalities of perception and movement … At two levels, the recognition of the passive by the active and of the active by the passive, of the person spoken to by the speaker, is projection and introjection … He is the person spoken to, i.e. an offshoot of myself, outside, my double, … because I make him do everything I do and he makes me do the same” (Merleau-Ponty 1973, pp. 19–20, my emphases).

  31. 31.

     Object-perception requires the ongoing synthesis or binding of (1) the currently experienced aspect with (2) the aspects not available to current perception and (3) a totality or unity of aspects that is never actually given in terms of the one aspect. The type or schema implicitly organizes the aspects of an object into a coherent relationship of perceptual meaning prior to its conscious perception. The fact that the object type or schema is already activated at this level of object recognition and is responsible for the inner mutual coherence of aspects or views of the object (as variants of the object’s core but invariant perceptual meaning) allows for the seamless transition from an object’s prelexical identification in visual perception to its linguistic expression in conscious, explicit judgments. (However, conscious awareness of the object does not itself require this transition to verbal naming) (see Uhlhaas and Mishara 2007).

  32. 32.

     My experience of mind as “inner” may, in part, be the artifact of my simulation of the other’s perspective combined with my own reflective thinking. That is, reflection reconstructs the self as a me or object located in the body in the same way that I experience others experiencing me. In each case, I take an external relationship to myself as “having” a body, or “having” a self.

  33. 33.

     Sartre’s (1966) celebrated analysis of the “Look” indicates a similar structural relationship between self and other to the mirror image (Stawarska, 2004). In Sartre’s account, the peeping Tom, by peering through the keyhole, transforms the target’s body into an “object” (without concern for the other’s “inner” subjective bodily experience). As the peeping Tom hears footsteps coming up the stairs, the objectifying “look” he had just exercised is now reversed on him. With the prospect of being caught in the act, he anticipates how someone else might see him, an object of (self-conscious) shame in the eyes of the other.

  34. 34.

     Similarly for vision, “I cannot see myself in movement, witness my own movement.” (Merleau-Ponty 1968, p. 254). For example, the orienting “kinaestheses,” i.e., ocular motor movements, are not themselves conscious when I view the things the orienting makes possible (Claesges, 1964; Husserl 1997).

  35. 35.

     Nowak and Bullier (1997) coined the term “fast brain” for the fronto-parietal connectivity of the dorsal pathways which, according to the Goodale Milner model, mediate implicit visuomotor control (as well as sensori-motor transformations from other sensory modalities necessary for this control). That is, information coming from the peripheral visual field “has access to fast, direct pathways that allow for faster onset times in dorsal stream areas.” Moreover, we may conclude that the function of frontodorsal connectivity is the “monitoring of peripheral stimuli in general” (Stephen et al. 2002, p. 3072). Remarkably, such a system of self as prospective openness, i.e., the ability to be affected by any point in its experiential field (structured by momentary, possible movement) prior to focal awareness had been anticipated by Husserl (Mishara 2005). The location in the field is prospectively structured by the “kinaestheses” of ocular motor response, i.e., by a potential field that is structured (nonconsciously) in terms of possible movements (i.e., eye-centered coordinates) required to reorient optimally to the novel target (Claesges 1964; Husserl 1997; Mishara 2005).

  36. 36.

     Merleau-Ponty (1968) writes: By means of “reversibility … alone, there is passage from the ‘for itself to the ‘for the Other’” (i.e., from body for self to body for others)) “They are each the other side of the other.” (p. 263). “The body sensed and the body sentient are the obverse and the reverse … as two segments of one sole circular course … which is but one sole movement in phases” (p. 138, my emphasis, see discussion of “Gestalt-circle,” below).

  37. 37.

     Since ‘mechanical kinesthesis’ (along with vestibular, efferent and other sensory modalities) may be regarded as contributing to body schema, and body schema is primarily unconscious, it is not surprising that visual information would indeed seem “richer” to awareness than its nonconscious counterpart. However, it would be incorrect to conclude that the information (i.e., computations of body schema) are any less complex than body image (see the above discussion of the double who turns his head with the same (computational) complexity as the self in the case of polyopic heautoscopy).

  38. 38.

    The “illusory” experience of movement, for example, in virtual reality (and possibly, OBEs), however, does not solely depend on the direction of flow of the optic array. The perception of depth during “self-movement” in VR (and otherwise) also rests on motion parallax, the relative retinal image motion between objects at different distances (and therefore, egocentric computations). That is, closer objects should move more quickly in comparison to more distant objects relative to one’s current movement speed. The objects’ location relative to self during motion parallex is subserved by dorsal stream (area MT) in macaque monkeys and presumably, humans (Nadler et al. 2008).

  39. 39.

     Metzinger states that the “consciously experienced egocentric frame of reference” - what I claim is neurobiologically implausible, see below - is the origin of the visual perspective and, during OBEs need not “occupy” any space at all for its mobile purview over the world and the body-object from which it has detached. In fact, some researchers (e.g., Bünning and Blanke 2005) share Metzinger’s (2003, 2005) view that the vantage point of OBEs is an “egocentric visuo-spatial perspective.” However, there are problems with this assertion: (1) Metzinger also writes, “the way in which OBE subjects move around in the currently active model of reality is not smooth, as in walking or flying, but occurs in discrete jumps from one salient point in the cognitive map to the next.” That is, from Metzinger’s own observation, it seems that the experience of movement in the OBEs is tracked in terms of an allocentric frame of reference or “cognitive map.” Since the movement itself appears to be tracked in the allocentric coordinates, it is not clear how the subject would become aware of its egocentric perspective. We have repeatedly emphasized in the phenomenological analysis that the egocentric coordinates of the prospectively acting subject (e.g., the path structure in ocular motor response, or throwing/catching a ball) are already past and not directly available to the ‘subsequent’ reflexive awareness, “I move myself” (mediated by the ‘faster’ already occurring perception-action cycle, or Gestalt-circle between movement and perception). (2) Metzinger contends that “OBEs are like a perceptualized variant of reflexive self-consciousness” (2003, p. 502). However, this would require that the egocentric perspective be available to reflexive awareness, which (I have argued) is not supported by the phenomenological evidence.

  40. 40.

    The philosophically minded sense-physiologist, neurologist and celebrated “founder” of psychosomatic medicine in Germany, Viktor von Weizsäcker, had tremendous impact on existential-phenomenological approaches in German-speaking psychiatry, as well as on Merleau-Ponty (described here) and Gadamer (1976, 1993). However, with the exception of a few researchers (e.g., Fuster 2006), he is practically unknown in English-speaking research (see Uhlhaas and Mishara 2007; Mishara 2004).

  41. 41.

     Unlike body image, the (egocentric) computations of a non-conscious, short-lived, prospectively open body-schema exhibits an adaptive plasticity that is not confined to the self-enclosed (already past) unity of the predominantly visual body image. For example, my body schema momentarily becomes the baseball-glove catching the ball, the cane I use to walk, or the top-hat I am wearing as I automatically stoop while walking beneath a low bridge. The body schema is able to incorporate tools as if “our own effector (e.g., the hand) were elongated to the tip of the tool” (Maravita and Iriki 2004, p. 79).

  42. 42.

     Similarly, von Weizsäcker and his assistants (reviewed by von Weizsäcker (1950)) observed during the experimental induction of vertigo that - in addition to the optokinetic nystagmus - rapid, adaptive movements with the head, torso and arms in the direction of the movement (often not perceived by the subject) play an organizing role in maintaining relationship with the disrupted perceptual experience. As with the train example, the illusion of self-movement (vection) during vertigo does not arise solely from the visual perception but from an embedded, enactive subject who maintains the coherence of his ongoing experience by making adjustments in the balance of perceptual and motor systems. See (Mishara in press a) for the impact of von Wiezsäcker’s vertigo induction experiments on Conrad’s and Binswanger’s phenomenlogical approach to delusions in schizophrenia.

  43. 43.

     For Metzinger (2005) expectation plays an important role in generating the illusory movement in the train example: “At the same time there was a state of general physical and emotional arousal, accompanied by an unconscious state of expectancy about what is very likely going to happen next, and very soon.” (p. 61). If expectation plays such a role in ‘selecting the interpretation’ in a “system that always tries to maximize overall coherence,” how is it that there is no incongruency felt by the fact that the illusory self-movement of one’s own train (i.e., going backwards) is precisely opposite to the direction expected? It is precisely because the movement is unexpected that it presents a momentary “crisis” for the subject (von Weizsäcker 1950, see also below). It therefore elicits a compensatory involvement of the motoric body schema reflected (in part) by the unnecessary movements of the subject (especially if standing in the train cabin) to maintain balance. Critically, Metizinger’s use of the term “coherence” depends on a different concept of subjectivity (as self-model) than von Weizsäcker’s (see Dissociating Mind and Subjectivity, below).

  44. 44.

     The Gestalt-circle occurs according to a “revolving door principle” (Drehtuerprinzip): “Each act is perception and movement. However, I am unable to perceive in my perception the movement that made it possible. Conversely, I am unable to access in the movement the perception that guides it. … Movement and perception stand in a relationship of mutual concealment” von Weizsäcker (1950), p. 200, my translation). The relationship is circular in the sense that one is “unable to ever establish where the relationship begins or ends” (von Weizsäcker, 1997 (1933), p. 26; my translation).

  45. 45.

     “In my view, the method most suitable for the matter described here never makes the Gestalt itself available for analysis but always the limits of its appearing and disappearing, that is, the conditions of its formal principles and not its content” (von Weizsäcker 1948, p. 11). While phenomenological purists may object that this method is “non-phenomenological,” it is, in actuality, very close to Husserl’s phenomenological method. It examines meaningful coherence of the Gestalt in terms of its limits (i.e., when the Gestalt loses its form or is no longer meaningful (e.g., vertigo-induction experiments von Weizsäcker 1950) and thus, resembles Huserl’s second step of eidetic imaginative variation outlined above.

  46. 46.

     Gallagher (2004) writes: “… self-knowledge conceived as this first person access is immune to error through misidentification … when I say “I think X,” I can be mistaken about X, but I cannot be mistaken about to whom the ‘I’ refers. Self-reference is guaranteed. For this, however, it is all the more impoverished. It remains a formal principle, nothing more than a transcendental index that accompanies every experience in life that is meaningful (Kant).” (p. 8).

  47. 47.

     I am indebted to Peter Brugger for bringing my attention to this case as an example of symbolic (he)autoscopy.

  48. 48.

     We experience our consciousness as an obligatory displacing itself with each new now. Nevertheless, we do not have reflective access to this process which is fundamentally self (Mishara 2007b). As Husserl writes, “the streaming is always ahead (im voraus) …” Any representation of self is already past (having a self), with its own closure (i.e., encoded in allocentric coordinates). This retrospective unity (body-image) cannot replace my current openness to a future, an incomplete openness with each new now moment. Self as this process of self-transcendence is reflected in Sartre’s (1966) famous phrase, “existence precedes essence” where essence (citing Hegel) is “what is already past”: “Wesen ist, was gewesen ist” (See Mishara 2004, 2007a).

  49. 49.

     With regard to intruder (FOP) and incubus hallucinations, Cheyne (2003) remarks, “there also appears to be a link between visual association areas, object identification (implicated by the ventral stream involvement), and limbic activity.” (p. 165). This concurs with our hypothesis that autoscopy-related disorders involve a disruption of relationship between body image and body schema, mediated by ventral and dorsal visual processing streams, respectively (see also Mishara 2005, 2007a).

  50. 50.

     See, for example, the description of the patient (Case 4) who experiences his own body as “paralyzed,” but whose vantage point alternates between the double and immobile body self.

  51. 51.

     Similarly Gadamer (1976) (citing von Weizsäcker (1950)), writes about playing an athletic game, which, by definition, is both cooperative and competitive: “the game is … the formation of the movement as such, which in an unconscious teleology subordinates the attitude of the individuals to itself… neither partner alone constitutes the real determining factor, rather, it is the unified movement as a whole that unifies the activity of both. We can formulate this as a theoretical generalization by saying that the individual self, including his activity and understanding of himself, is taken up into a higher determination that is really the decisive factor” (pp. 53–54).

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Mishara, A.L. (2010). Autoscopy: Disrupted Self in Neuropsychiatric Disorders and Anomalous Conscious States. In: Schmicking, D., Gallagher, S. (eds) Handbook of Phenomenology and Cognitive Science. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-2646-0_30

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